In Vitro Comparison of a Single-Layer (Continuous Lembert) versus Two-Layer (Simple Continuous/Cushing) Hand-Sewn End-to-End Jejunoileal Anastomosis in Normal Equine Small Intestine

Objectives To compare in vitro physical and mechanical characteristics of 1‐layer and 2‐layer end‐to‐end jejunoileostomy. Study Design In vitro experimental study. Animals Adult horses (n = 6). Methods Harvested equine jejunum and ileum was used to create 1‐ and 2‐layer end‐to‐end jejunoileostomy sp...

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Bibliographic Details
Published in:Veterinary surgery 2012-07, Vol.41 (5), p.589-593
Main Authors: Lee, Wesley L., Epstein, Kira L., Sherlock, Ceri E., Mueller, P.O. Eric, Eggleston, Randall B.
Format: Article
Language:English
Subjects:
Anastomosis, Surgical - methods
Anastomosis, Surgical - veterinary
Animals
Cadaver
Comparative studies
Female
Gastrointestinal surgery
Horses
Intestine, Small - surgery
Male
Small intestine
Surgical outcomes
Suture Techniques - veterinary
Sutures
Veterinary services
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Summary:Objectives To compare in vitro physical and mechanical characteristics of 1‐layer and 2‐layer end‐to‐end jejunoileostomy. Study Design In vitro experimental study. Animals Adult horses (n = 6). Methods Harvested equine jejunum and ileum was used to create 1‐ and 2‐layer end‐to‐end jejunoileostomy specimens. Construction time, bursting pressure, and relative lumen diameter (anastomosis diameter expressed as a percentage of the lumen diameter of adjacent jejunum and ileum) were compared. Construction time and relative lumen diameters were compared using a paired t‐test. Bursting pressure for anastomoses and control jejunal segments were compared using a repeated‐measure ANOVA. Statistical significance was set at P < .05. Results Mean (±SEM) construct completion times were shorter for 1 layer (21 ± 0.91 minutes) than 2 layers (26.71±1.16 minutes; P = .005). Relative lumen diameters (percentage of jejunal diameter) were larger for 1 layer (77.67 ± 4.46%) than for 2 layers (69.37 ± 2.8%; P = .035). There were no significant differences in bursting pressures between the 2 groups and the control jejunum (P =.155) or relative lumen diameters (percentage of ileal diameter; P =.118). Conclusions One‐layer jejunoileostomy can be created in a shorter time and maintain a larger anastomosis luminal diameter without compromising maximum bursting pressure when compared to 2‐layer jejunoileostomy.
ISSN:0161-3499
1532-950X
DOI:10.1111/j.1532-950X.2012.00997.x